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The psychopathology of 29 delinquent and 25 nondelinquent psychiatrically hospitalized adolescent boys was similarly severe. Similar proportions had hallucinations, delusions, learning disabilities, and evidence of neurological impairment, and over half in each group had been diagnosed as being psychotic. Fire-setting, enuresis, and cruelty to animals did not distinguish the two groups. Significantly more of the delinquents had been psychiatrically hospitalized previously, and significantly more of the delinquents had engaged in violently aggressive acts. The household composition of both groups was similar, but more mothers of delinquents than of nondelinquents had been psychiatrically hospitalized. The authors discuss the issue of the treatment of psychiatrically ill violent adolescents.

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Of 55 children admitted to a children's psychiatric service, 21 were homicidally aggressive. Psychiatric symptoms and diagnoses did not distinguish these children from the nonhomicidal children, but the homicidally aggressive children were significantly more likely to 1) have a father who behaved violently, often homicidally, 2) have had a seizure, 3) have attempted suicide, and 4) have a mother who had been hospitalized for a psychiatric disorder. The authors explore explanations for the contribution of these factors to juvenile violence.

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This study documents a high prevalence of medical disorders, especially head and face injury, seizures, and other neurological problems in violent incarcerated adolescent delinquents. It documents the failure of three different medical specialities--pediatrics, psychiatry, and neurology--to consistently elicit significant potentially treatable disorders during routine evaluations. It explores possible causes for overlooking significant medical factors in these youngsters and proposes ways to improve the health evaluations of delinquent adolescents.

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The authors report the finding of psychomotor epilepsy in 18 of 97 incarcerated delinquent boys. Number of psychomotor symptoms was correlated with degree of violence in the members of this group. In addition, psychomotor symptoms were correlated more strongly with certain psychotic symptoms than with soft neurological signs or intellectual deficits. The relationship of violence to ictal and interictal states is explored.

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The medical histories (based on hospital records) of matched samples of nonincarcerated delinquent girls, incarcerated delinquent girls, and nondelinquent girls were compared. Numbers of visits, timing of visits, services used, and reasons for hospital contacts were compared for the three groups. Delinquent girls in general had significantly more adverse medical histories than nondelinquent girls; they made significantly more hospital visits and had significantly more accidents and injuries through age 21 years. Perinatal difficulties did not distinguish these two groups. Although incarcerated and nonincarcerated delinquent girls made similar numbers of hospital visits, their histories differed qualitatively. Accidents and injuries, head and face injuries, perinatal difficulties, neurologic abnormalities, and child abuse were found more frequently in the histories of incarcerated girls. These findings have etiologic importance to the development of seriously delinquent behavior.

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The medical histories of 12 abused and 69 nonabused incarcerated delinquent children from the same geographic area were compared. Children who were abused had significantly more hospital visits, emergency room visits, ward admissions, accidents, (especially head and face trauma), and respiratory illnesses through age 16. Perinatal difficulties and psychiatric symptoms were more prevalent in the histories of abused delinquents than in those of nonabused delinquents. The authors discuss the role of child abuse in the development of serious delinquent behaviors.

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The authors compared psychiatric symptoms, violent behaviors, and medical histories of an entire one-year sample of adolescents from the same community who were sent either to the correctional school or the only state hospital adolescent psychiatric unit serving the area. The initial hypothesis that the incarcerated group would be equally disturbed but more violent than the hospitalized group was contradicted. Violence as well as severe psychiatric symptomatology was equally prominent in the two groups. The most powerful variables distinguishing the groups were race, accidents, and injuries (especially head injury), and sex. The medical and social implications of the findings are discussed.

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The authors studied the first 88 adolescents boys who were placed on the secure unit of a correctional school during an 18-month period and found that 52 (59.1%) of the boys had previously received psychiatric residential treatment or psychiatric hospitalization. The authors hypothesize that many of these boys may have been transferred from a psychiatric setting to a correctional facility during adolescence when long-standing aberrant behaviors became more threatening to staff. At present the number of psychiatric hospital beds is decreasing and the criteria for hospitalization of children are becoming more stringent. The data indicate that correctional facilities are now expected to function as psychiatric treatment centers for disturbed adolescents no longer welcome in therapeutic settings.

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The authors compared the medical histories of incarcerated and nonincarcerated delinquent children. Incarcerated delinquent children were significantly more likely than nonincarcerated delinquents to have sustained severe head and face injury. Differences were evident by age 2. Perinatal difficulties and psychiatric impairment were also significantly more prevalent in the histories of incarcerated delinquents. Especially violent incarcerated children had more perinatal difficulties, accidents, injuries, and ward admissions than did their less violent incarcerated peers. The authors suggest that the combination of early CNS trauma, parental psychopathology, and social deprivation is responsible for the serious, often violent, delinquency that is now prevalent.

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In clinical practice the authors observed that many of the delinquent children of psychiatrically impaired and/or criminal parents had remarkably adverse health histories. To test their clinical impression they systematically compared the medical histories of 20 delinquent children with criminal parents and 85 delinquent children with less obviously maladapted parents. They found a strong association between paternal criminality and serious medical problems in these delinquent children. On the basis of this finding the authors suggest that the behavioral manifestations resulting from such physical illness or neglect, although they appear genetic in nature, may reflect the physical and psychological consequences of parental neglect and/or battering.

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